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Exercise renography in untreated subjects with essential hypertension
E J Fine1, M D Blaufox, J D Blumenfeld
1Department of Nuclear Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.
Summary
Exercise can cause kidney problems in hypertensive patients, but not in those with normal blood pressure. This dysfunction appears linked to hypertension itself, not medication, affecting about half of individuals with mild to moderate hypertension.
Area of Science:
- Nephrology
- Cardiology
- Nuclear Medicine
Background:
- Exercise-induced renal dysfunction is documented in treated hypertensive patients.
- It remains unclear if this dysfunction relates to hypertension or its treatment.
Purpose of the Study:
- To investigate exercise-induced renal dysfunction in hypertensive patients off medication.
- To determine if the phenomenon is linked to essential hypertension or antihypertensive therapy.
Main Methods:
- Radionuclide renography was performed on 15 hypertensive subjects (off medication) and 4 healthy volunteers.
- Studies were conducted at rest and during bicycle exercise, with analysis of renal transit time.
- Radiotracers used included [123I]orthoiodohippurate (OIH) and 99mTc-mercaptoacetyltriglycine (MAG3).
Main Results:
- Abnormal renal transit during exercise was observed in 7 of 14 hypertensive subjects, but not in controls.
- This exercise-induced abnormality was absent during resting renography.
- Four of the seven affected hypertensive subjects had a history of hypertension for 2 years or less.
Conclusions:
- Approximately 50% of individuals with mild-to-moderate hypertension and normal renal function may exhibit abnormal renal transit during exercise.
- This finding suggests a direct link to the pathophysiology of essential hypertension, independent of therapy.